Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.079
Mais filtros

Intervalo de ano de publicação
PLoS One ; 16(10): e0257757, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34606508


CONTEXT: The Covid-19 pandemic hit the developed world differentially due to accidental factors, and countries had to respond rapidly within existing resources, structures, and processes to manage totally new health challenges. This study aimed to identify which pre-existing structural factors facilitated better outcomes despite different starting points, as understanding of the relative impact of structural aspects should facilitate achieving optimal forward progress. METHODS: Desk study, based on selecting and collecting a range of measures for 48 representative characteristics of 42 countries' demography, society, health system, and policy-making profiles, matched to three pandemic time points. Different analytic approaches were employed including correlation, multiple regression, and cluster analysis in order to seek triangulation. FINDINGS: Population structure (except country size), and volume and nature of health resources, had only minor links to Covid impact. Depth of social inequality, poverty, population age structure, and strength of preventive health measures unexpectedly had no moderating effect. Strongest measured influences were population current enrolment in tertiary education, and country leaders' strength of seeking scientific evidence. The representativeness, and by interpretation the empathy, of government leadership also had positive effects. CONCLUSION: Strength of therapeutic health system, and indeed of preventive health services, surprisingly had little correlation with impact of the pandemic in the first nine months measured in death- or case-rates. However, specific political system features, including proportional representation electoral systems, and absence of a strong single party majority, were consistent features of the most successful national responses, as was being of a small or moderate population size, and with tertiary education facilitated. It can be interpreted that the way a country was lead, and whether leadership sought evidence and shared the reasoning behind resultant policies, had notable effects. This has significant implications within health system development and in promoting the population's health.

COVID-19/patologia , Democracia , COVID-19/epidemiologia , COVID-19/mortalidade , COVID-19/virologia , Serviços Médicos de Emergência , Política de Saúde , Humanos , Pandemias , Saúde Pública , Resiliência Psicológica , SARS-CoV-2/isolamento & purificação , Fatores Socioeconômicos
PLoS One ; 16(9): e0256737, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34492045


Due to increasing demand and scarce financial resources for healthcare, health system efficiency has become a major topic in political and scientific debates. While previous studies investigating determinants of health system efficiency focused primarily on economic and social influence factors, the role of the political regime has been neglected. In addition, there is a lack of formal theoretical work on this specific topic, which ensures transparency and logical consistency of arguments and implications. Using a public choice approach, this paper provides a rigorous theoretical and empirical investigation of the relationships between health system efficiency and political institutions. We develop a simple principal-agent model describing the behavior of a government with respect to investments in population health under different political regimes. The main implication of the theoretical model is that governments under more democratic regimes put more effort in reducing embezzlement of health expenditure than non-democratic regimes. Accordingly, democratic countries are predicted to have more efficient health systems than non-democratic countries. We test this hypothesis based on a broad dataset including 158 countries over the period 1995-2015. The empirical results clearly support the implications of the theoretical model and withstand several robustness checks, including the use of alternative indicators for population health and democracy and estimations accounting for endogeneity. The empirical results also indicate that the effect of democracy on health system efficiency is more pronounced in countries with higher income levels. From a policy perspective, we discuss the implications of our findings in the context of health development assistance.

Democracia , Política de Saúde/legislação & jurisprudência , Sistemas Políticos , Política , Programas Governamentais/economia , Programas Governamentais/legislação & jurisprudência , Política de Saúde/economia , Humanos , Saúde da População
PLoS One ; 16(9): e0257557, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34543334


OBJECTIVES: Empathy is fundamental to social cognition, driving prosocial behaviour and mental health but associations with aging and other socio-demographic characteristics are unclear. We therefore aimed to characterise associations of these characteristics with two main self-reported components of empathy, namely empathic-concern (feeling compassion) and perspective-taking (understanding others' perspective). METHODS: We asked participants in an internet-based survey of UK-dwelling adults aged ≥18 years to complete the Interpersonal Reactivity Index subscales measuring empathic concern and perspective taking, and sociodemographic and personality questionnaires. We weighted the sample to be UK population representative and employed multivariable weighted linear regression models. RESULTS: In 30,033 respondents, mean empathic concern score was 3.86 (95% confidence interval 3.85, 3.88) and perspective taking was 3.57 (3.56. 3.59); the correlation between these sub-scores was 0.45 (p < 0.001). Empathic concern and perspective taking followed an inverse-u shape trajectory in women with peak between 40 and 50 years whereas in men, perspective taking declines with age but empathic concern increases. In fully adjusted models, greater empathic concern was associated with female gender, non-white ethnicity, having more education, working in health, social-care, or childcare professions, and having higher neuroticism, extroversion, openness to experience and agreeableness traits. Perspective taking was associated with younger age, female gender, more education, employment in health or social-care, neuroticism, openness, and agreeableness. CONCLUSIONS: Empathic compassion and understanding are distinct dimensions of empathy with differential demographic associations. Perspective taking may decline due to cognitive inflexibility with older age whereas empathic concern increases in older men suggesting it is socially-driven.

Empatia , Fatores Socioeconômicos , Adolescente , Adulto , Fatores Etários , Idoso , Estudos Transversais , Democracia , Escolaridade , Feminino , Humanos , Internet , Masculino , Pessoa de Meia-Idade , Personalidade , Inquéritos e Questionários , Reino Unido
RECIIS (Online) ; 15(3): 736-749, jul.-set. 2021. ilus
Artigo em Português | LILACS | ID: biblio-1342700


"A questão que atravessa tudo que faço são as disputas em torno do próprio sentido da democracia". Assim, a pesquisadora Flávia Biroli compreende sua trajetória na ciência. Em entrevista à Reciis, comenta sobre suas pesquisas que perpassaram a interface comunicação e política e seus estudos mais recentes sobre gênero e democracia. Biroli discute o que denomina de neoconservadorismo, que se dá por alianças de diferentes atores conservadores de escala transnacional as quais atuam contra as agendas de igualdade de gênero e diversidade sexual. Tais ações se utilizam da dimensão moral e de valores tradicionais 'de família' como justificativas para a promoção de processos de erosão da democracia. Em relação aos feminismos, entende que, tanto na expressão acadêmica quanto na expressão política, o diagnóstico interseccional das opressões de gênero é central para a compreensão e para solidariedades sociais e resistências políticas. Em contexto de pandemia, Biroli discorre sobre seus efeitos nas mulheres, mais responsabilizadas pelas práticas do cuidado. Para a pesquisadora, pensar nos modos de organização social que levam em conta relações de dependência e vulnerabilidade é também pensar na constituição de uma sociedade mais justa e sustentável. Flávia Biroli é professora associada do Instituto de Ciência Política da Universidade de Brasília (UnB).

"The issue that runs through everything I do are the disputes over the very meaning of democracy." It is with these words that the researcher Flávia Biroli understands her path in science. In an interview for Reciis, she comments on her research that permeated the interface between communication and politics and her most recent studies on gender and democracy. Biroli discusses what she calls neoconservatism, which occurs through alliances of different conservative actors on a transnational scale, which act against the agendas of gender equality and sexual diversity. Such actions use the moral dimension and traditional 'family' values to justify promoting processes of erosion of democracy. In relation to feminisms, Biroli states that, both in academic and political expression, the intersectional diagnosis of gender oppression is paramount to understanding and to performing social and political solidarities. In the pandemic context, Biroli discusses its effects on women, who are more responsible for care practices. In her point of view, thinking about ways of social organization that take into account relations of dependency and vulnerability is also thinking about the formation of a fairer and more sustainable society. Flávia Biroli is an associate professor at the Institute of Political Science at the University of Brasília (UnB).

"El tema que atraviesa todo lo que hago son las disputas sobre el significado mismo de la democracia". Así la investigadora Flávia Biroli comprende su trayectoria en la ciencia. En entrevista a Reciis, Biroli comenta sus investigaciones que impregnaran la interfaz comunicación-política y sus estudios más recientes sobre género y democracia. Biroli discute lo que llama neoconservadurismo, que ocurre a través de alianzas de diferentes actores conservadores en escala transnacional, que actúan en contra de las agendas de igualdad de género y diversidad sexual. Estas acciones utilizan la dimensión moral y los valores tradicionales de la 'familia' como justificación para promover procesos de erosión de la democracia. En relación a los feminismos, Biroli entiende que tanto en la expresión académica como en la expresión política el diagnóstico interseccional de la opresión de género es central para la comprensión y el desempeño de las solidaridades sociales y políticas. En contexto de pandemia, Biroli analiza sus efectos en las mujeres, que son más responsables de las prácticas de atención. La investigadora cree que pensar em formas de organización social que tengan en cuenta las relaciones de dependencia y vulnerabilidad es también pensar en la constitución de una sociedad más justa y sostenible. Flávia Biroli es profesora asociada del Instituto de Ciencias Políticas de la Universidad de Brasilia (UnB).

Humanos , Política , Feminismo , Democracia , Empatia , Acesso à Informação , Expressão de Gênero , Diversidade de Gênero , Equidade de Gênero
Health Aff (Millwood) ; 40(8): 1234-1242, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34339254


Despite widespread recognition that universal health coverage is a political choice, the roles that a country's political system plays in ensuring essential health services and minimizing financial risk remain poorly understood. Identifying the political determinants of universal health coverage is important for continued progress, and understanding the roles of political systems is particularly valuable in a global economic recession, which tests the continued commitment of nations to protecting their health of its citizens and to shielding them from financial risk. We measured the associations that democracy has with universal health coverage and government health spending in 170 countries during the period 1990-2019. We assessed how economic recessions affect those associations (using synthetic control methods) and the mechanisms connecting democracy with government health spending and universal health coverage (using machine learning methods). Our results show that democracy is positively associated with universal health coverage and government health spending and that this association is greatest for low-income countries. Free and fair elections were the mechanism primarily responsible for those positive associations. Democracies are more likely than autocracies to maintain universal health coverage, even amid economic recessions, when access to affordable, effective health services matters most.

Recessão Econômica , Cobertura Universal do Seguro de Saúde , Democracia , Gastos em Saúde , Serviços de Saúde , Humanos , Sistemas Políticos
Environ Sci Pollut Res Int ; 28(44): 62927-62942, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34218384


Since the developed world's economic prosperity has been heavily reliant on excessive fossil-based energy consumption, it has posed severe environmental quality challenges. This research attempts to revisit the relationship between income and anthropogenic emissions in the context of the environmental Kuznets curve (EKC) theory by considering electric power consumption, urbanization, and democratic accountability index in the Gulf Cooperation Council (GCC) region. It employs annual frequency panel data from 1990 through 2019 and three alternative advanced econometric estimation techniques. The main findings are as follows: Firstly, the EKC results for the whole sample strongly support the proposition of an inverse U-shaped connection between anthropogenic emissions and affluence in the long run. Secondly, the country-specific results confirm EKC only in Saudi Arabia and Bahrain, while the remaining countries demonstrate a U-shaped connection. Thirdly, the democratic accountability promoted anthropogenic emissions implying that it failed to contribute to environmental protection. It means that democratic setup in the GCC region performs poorly in accomplishing climate change mitigation and Sustainable Development Goals (SDGs). Fourthly, electric power consumption and urbanization impart positive and negative impacts on anthropogenic emission, respectively. These findings are found robust across the fully modified ordinary least square (FMOLS), bias-corrected LSDV (least squares dummy variable) (LSDV), and pooled mean group (PMG) estimators. Finally, Dumitrescu-Hurlin panel causality shows that (i) income and urbanization establish a two-way causality with the anthropogenic emissions. (ii) However, a unidirectional causal connection is revealed from electric power consumption and democratic accountability index to anthropogenic emissions. The findings suggest that the GCC region should prioritize environmental protection and SDGs across the political aims' recipe since it would direct the region on the path of climate change mitigation.

Dióxido de Carbono , Desenvolvimento Econômico , Democracia , Renda , Urbanização
Soc Sci Med ; 283: 114190, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34242889


BACKGROUND: Income inequality is associated with poor health when economic disparities are especially salient. Yet, political institutions may alter this relationship because democracies (as opposed to autocracies) may be more inclined to frame inequalities in negative rather than positive ways. Living in a particular political system potentially alters the messages individuals receive about whether inequality is large or small, good or bad, and this, in turn, might affect whether beliefs about inequality influence health. Further, media coverage of economic inequality may negatively affect health if it contributes toward the general perception that the gap between rich and poor has gone up, even if there has been no change in income differentials. METHODS: In this study, we explore the relationship between democracy, perceptions of inequality, and self-rated health across 28 post-communist countries using survey and macro-level data, multilevel regression models, and inverse probability weighting to estimate the average treatment effect on the treated. RESULTS: We find that self-rated health is higher in more democratic countries and lower among people who believe that inequality has risen in the last few years. Moreover, we observe that people in democracies are more likely to learn about rising inequality through watching television and that when they do it has a more harmful effect on their health than when people in autocracies learn about rising inequality through the same channel, suggesting that in countries where there is less trust in the television media learning about rising inequality is not as harmful for health. CONCLUSIONS: Our results indicate that while democracies are generally good for well-being, they may not be unambiguously positive for health. This does not mean, of course, that inequality is good for health nor that, on average, autocracies have better health than democracies; but rather that being more aware of inequality can negatively affect self-rated health.

Democracia , Renda , Humanos , Análise Multinível , Sistemas Políticos , Fatores Socioeconômicos
Sociol Health Illn ; 43(6): 1518-1539, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34263470


For two decades, New Zealand has been placed consistently at the foot of OECD rankings for state expenditure on pharmaceuticals. In this article, we explore New Zealand's containment of pharmaceutical spending as a 'divergent' case of pharmaceutical policy in a liberal democracy. To elucidate the likely institutional mechanisms and interests behind this phenomenon, we conducted a case study of New Zealand's drug reimbursement policy. In doing so, we derived sensitising concepts from major accounts of pharmaceutical policymaking (Corporate Bias Theories and Reputational Theory) and theories of the western state (Historical Institutionalism and Corporate Domination Theory). Drawing on 28 expert interviews and documentary analysis, we identified three main mechanisms of spending containment. First, New Zealand's state bureaucracy use pricing strategies that rely on a spending containment strategy coordinated by bureaucratic managers. Second, these managers shape the policy preferences of expert committees involved in scientific drug assessment. Third, on a meta-level, conditions for spending containment are enabled by the judicial-legislative arena. As such, we find support for Historical Institutionalism and Reputational Theory and more limited support for Corporate Bias Theory and Corporate Domination Theory. Our explanation posits further conceptual linkages between the macro/societal and meso-organisational theoretical levels.

Democracia , Preparações Farmacêuticas , Capitalismo , Humanos , Políticas , Formulação de Políticas
Inquiry ; 58: 469580211024894, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34253073


Cancer is one of the leading causes of death globally and expenditure associated with cancer is quite high. Efficient resource allocation needs information on economic evaluations of healthcare interventions. The purposes of the study are to provide a comprehensive overview of cancer patients' willingness to pay (WTP) for healthcare services and to investigate the influence of democracies, culture dimensions, and other factors on WTP. A meta-analysis was conducted using PubMed, Scopus, and Google Scholar to identify all studies of stated preference approach to estimate cancer patients' WTP healthcare services. A set of criteria was constructed for selecting relevant studies. A total of 79 studies were related to selection criteria and held sufficient information for the purposes of meta-analysis. A total of 393 estimates of WTP from 79 healthcare valuation studies were pooled to identify the links between WTP and influential factors. The findings suggest that values of benefits in healthcare services are higher in more democratic nations, but they are lower in cultural traits that are stronger indulgence and uncertainty avoidance. Further, the types of cancer matter. Compared to breast cancer, WTP is higher for skin cancer, yet lower for liver cancer and lymphoma. A higher national income and public health expenditure increase WTP for healthcare services, while a higher death rate by cancer leads to lower values of healthcare benefits.

Neoplasias da Mama , Democracia , Atenção à Saúde , Feminino , Financiamento Pessoal , Serviços de Saúde , Humanos
Proc Natl Acad Sci U S A ; 118(11)2021 03 16.
Artigo em Inglês | MEDLINE | ID: mdl-33707215


The COVID-19 pandemic has changed peoples' lives in unexpected ways, especially how they allocate their time between work and other activities. Demand for online learning has surged during a period of mass layoffs and transition to remote work and schooling. Can this uptake in online learning help close longstanding skills gaps in the US workforce in a sustainable and equitable manner? We answer this question by analyzing individual engagement data of DataCamp users between October 2019 and September 2020 (n = 277,425). Exploiting the staggered adoption of actions to mitigate the spread of COVID-19 across states, we identify the causal effect at the neighborhood level. The adoption of nonessential business closures led to a 38% increase in new users and a 6% increase in engagement among existing users. We find that these increases are proportional across higher- and lower-income neighborhoods and neighborhoods with a high or low share of Black residents. This demonstrates the potential for online platforms to democratize access to knowledge and skills that are in high demand, which supports job security and facilitates social mobility.

Democracia , Educação à Distância/economia , COVID-19 , Ciência de Dados/educação , Educação à Distância/estatística & dados numéricos , Política de Saúde , Humanos , Pandemias , Fatores Socioeconômicos
Hastings Cent Rep ; 51 Suppl 1: S58-S63, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33630338


Forces including extreme economic inequality, cultural polarization, and the monetizing and privatizing of persons as commodities are undermining the forms of moral recognition and mutuality upon which democratic practices and institutions depend. These underlying factors, together with more direct modes of political corruption, manipulation, and authoritarian nationalism, are undoing Western democracies. This essay identifies and explores some vital underpinnings of democratic citizenship and civic learning that remain open to revitalization and repair. Building care structures and practices from the ground up and developing inclusive and egalitarian modes of solidarity in a pluralistic society are the focus of discussion. The essay argues that solidarity and care are essential relationships and practices of moral recognition upon which democratic political agency and freedom rest. The social-relational lifeworld and the democratic lifeworld are interdependent. Democratic citizenship is itself a relational practice that supports other practices. Democratic governance properly carried out fosters an underlying social solidarity and care and in turn draws moral and political legitimacy upward from them.

Democracia , Liberdade , Humanos , Princípios Morais
Scand J Public Health ; 49(1): 104-113, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33427079


AIMS: The COVID-19 pandemic has led to a spate of studies showing a close connection between inequitable access to health care, welfare services and adverse outcomes from the pandemic. Others have argued that democratic governments have generally failed relative to more autocratic ones, simply because autocrats can make the hard choices required for stemming the spread of viruses. We address this question by asking whether more 'egalitarian' forms of democracy matter, given that they contain more equitable health-care access and societal infrastructure, such as social capital and trust. METHODS: We use standard regression techniques, including instrumental variables analysis addressing endogeneity on COVID-19 testing and deaths data as of the end of May and beginning of September. We use novel data from the Varieties of Democracy Project on health-system equity and egalitarian democracy. RESULTS: Our results suggest that more equitable access to health care increases testing rates and lowers the death rate from COVID-19. Broader egalitarian governance, measured as egalitarian democracy, however, shows the opposite effect. Thus, factors associated with health-care capacity to reach and treat matter more than broader societal factors associated with social capital and trust. The results are robust to alternative testing procedures, including instrumental variable technique for addressing potential endogeneity. CONCLUSIONS: Despite a great deal of public health focus on how equitable governance helps fight the adverse effects of so-called neoliberal pandemics, we find that broadly egalitarian factors have had the opposite effect on fighting COVID-19, especially when an equitable health system has been taken into account. Fighting disease, thus, might be more about the capacity of health systems rather than societal factors, such as trust in government and social capital.

COVID-19/terapia , Atenção à Saúde/organização & administração , Democracia , Equidade em Saúde , COVID-19/epidemiologia , Pesquisa Empírica , Humanos , Resultado do Tratamento , Estados Unidos/epidemiologia
PLoS One ; 16(1): e0244071, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33471828


The emergence of a new tech elite in Silicon Valley and beyond raises questions about the economic reach, political influence, and social importance of this group. How do these inordinately influential people think about the world and about our common future? In this paper, we test a) whether members of the tech elite share a common, meritocratic view of the world, b) whether they have a "mission" for the future, and c) how they view democracy as a political system. Our data set consists of information about the 100 richest people in the tech world, according to Forbes, and rests on their published pronouncements on Twitter, as well as on their statements on the websites of their philanthropic endeavors. Automated "bag-of-words" text and sentiment analyses reveal that the tech elite has a more meritocratic view of the world than the general US Twitter-using population. The tech elite also frequently promise to "make the world a better place," but they do not differ from other extremely wealthy people in this respect. However, their relationship to democracy is contradictory. Based on these results, we conclude that the tech elite may be thought of as a "class for itself" in Marx's sense-a social group that shares particular views of the world, which in this case means meritocratic, missionary, and inconsistent democratic ideology.

Mídias Sociais , Tecnologia , Democracia , Desenvolvimento Econômico , Modelos Logísticos , Aprendizado de Máquina
Environ Sci Pollut Res Int ; 28(6): 7226-7235, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33029774


The main purpose of this study is to examine the democracy-environmental degradation nexus in 26 Organization for Economic Cooperation and Development (OECD) countries from 1990 through 2015 by using panel data estimation methods, performing well under cross-sectional dependence. Empirical results are as follows: (i) Tests show that cross-section dependence exists among panel members, and slope coefficients are heterogeneous, respectively, and (ii) long-term coefficient estimation results with Augmented Mean Group estimator show that democracy, non-renewable energy consumption, and real income per capita have statistically significant negative effects on environmental quality, whereas renewable energy consumption has a positive effect. There is also no statistically significant relationship between urbanization and environmental quality. These findings show the poor functioning of democracy in addressing environmental issues among OECD countries; therefore, raising environmental quality conflicts with the Sustainable Development Goals (SDGs) of creating strong institutions and economic growth targets. Moreover, promoting renewable energy consumption may be an effective alternative in reducing environmental degradation; therefore, it can be said that promoting clean energy use and raising the SDG environmental quality targets are in harmony.

Dióxido de Carbono , Democracia , Estudos Transversais , Desenvolvimento Econômico , Energia Renovável
São Paulo; s.n; 2021. 220 p.
Tese em Português | LILACS | ID: biblio-1337776


Este trabalho analisa, articuladamente, dois elementos subjacentes à questão democrática na saúde, o acesso universal e a participação social na saúde, com experiências de gestores municipais de saúde em 2019 e inícios de 2020. A tese central é a de que há uma crise no binômio saúde-democracia expressas nas questões do acesso aos serviços e da participação social na saúde e que tem, em seus aspectos originários e de expressão, as estratégias vitoriosas de implementação do projeto reformador na saúde pelo movimento sanitário ao final do século XX. Realizou-se uma pesquisa empírica, por meio de entrevistas semiestruturadas com cinco gestores locais da região do Grande ABC paulista. A análise desse material permitiu identificar que a universalização do acesso tem se materializado nos municípios em estudo pelo aumento substancial do consumo individual dos serviços médico-assistenciais e a radicalização de sua expansão culmina em um amplo processo de medicalização da sociedade. No caso da participação social na saúde, identificou-se que, no âmbito dos Conselhos de Saúde, desenvolve-se uma exercício participativo pobre em inovação social e esvaziado politicamente, o que revela as características históricas da primazia do Estado na formulação da política de saúde, bem como expressa as marcas do gerencialismo e da lógica do mercado características das sociedades capitalistas contemporâneas. Identificou-se, entretanto, que concomitantemente a esse processo, os municípios experienciam a emergência de novas formas de participação social por meio das tecnologias de informação e de comunicação, com publicações e manifestações dos indivíduos nas redes sociais. O conteúdo das publicações é imprevisível para a gestão pública e seus efeitos são impostos de maneira imediata na realidade virtual assim que as postagens são realizadas, ultrapassando os limites do espaço e do tempo das atividades governamentais clássicas.

This work articulates the analysis of two elements of the relation between health and democracy, which are the universal access and the social participation in health, with experiences of municipal health managers in 2019 and 2020. The central thesis adopted is that there is a crisis in the health-democracy binomial expressed in the issues of access and participation and which has, as one of its points of origin and expression, the successful strategies for implementing the health reform project by the sanitary movement at the end of the 20th century. The work is based on empirical research realized by semi-structured interviews with five local health managers in the ABC region of São Paulo. From the interviews, it was identified that the universalization of access has materialized in the municipalities due to the substantial increase in individual consumption of medical care services, in its most positive sense, and the radicalization of its expansion culminates in a broad process of medicalization of society. In the case of social participation in health, it was identified that, within the scope of the Health Councils, a participatory exercise is poor in social innovation and politically emptied, which highlights the historical characteristics of the primacy of the State in the formulation of health policy, while expressing the marks of managerialism and market logic that are characteristic of contemporary capitalist societies. Concomitantly, the municipalities has experienced a emergence of new forms of social participation through information and communication Technologies by publications and expressions of individuals on social networks. The content of the publications is unpredictable for public management, exceeding the limits of space and time of classic government activities.

Democracia , Participação Social , Acesso aos Serviços de Saúde
Textos contextos (Porto Alegre) ; 20(1): 37389, 2021.
Artigo em Português | LILACS | ID: biblio-1283194


O presente artigo tem por objetivo fazer uma análise da atual superestrutura, marcadamente neoliberal, de sustentáculo do corrente modelo de acumulação capitalista e suas implicações na democracia liberal burguesa e nos direitos humanos básicos, expressos em liberdades básicas, materializados em direitos de cidadania em cada país. Trata-se de um artigo resultante de pesquisa teórica, com metodologia qualitativa e escolha intencional de literatura de suporte. Conclui-se que esse projeto societário neoliberal e neoconservador que forma a atual nova direita colide, convive, (re)significa e esvazia a democracia e os que podem ou não ser considerados cidadãos e ter garantidos os seus direitos humanos.

This article aims to analyze the current markedly neoliberal superstructure supporting the current model of capitalist accumulation and the implications on bourgeois liberal democracy and human rights, expressed in basic rights and freedoms, embodied in citizenship rights in each parent. This is an article resulting from theoretical research, with qualitative methodology and intentional choice of supporting literature. It is concluded that this neoliberal and neoconservative societal project that forms the current New Right collides, coexists, (re)signifies and empties democracy and those who may or may not be considered citizens and have their human rights guaranteed.

Política , Democracia , Fatores Socioeconômicos